中西医结合治疗老年人早期糖尿病肾病临床观察

目的:观察中西医结合治疗老年人早期糖尿病肾病的临床疗效。方法:将92例早期糖尿病肾病患者随机分为两组,治疗组予自拟健脾补肾益气化瘀汤结合西药达美康治疗,对照组予以达美康、洛汀新常规处置;疗程均为2个月。结果:治疗组治愈率20.4%,总有效率87.8%,对照组治愈率14.0%,总有效率76.7%,治疗组疗效明显优于对照组(P<0.05)。结论:中西医结合治疗老年人早期糖尿病肾病疗效满意。     

健脾化湿汤治疗肠易激综合征30例临床观察

[目的]观察和评估中药健脾化湿汤治疗腹泻型肠易激综合征的临床疗效及安全性。[方法]将确诊为肠易激综合征的患者随机分2组进行对比观察。治疗组3例在一般治疗的基础上服中药健脾化湿汤;对照组30例在一般治疗的基础上用马来酸曲美布汀片。[结果]治疗3个月后,治疗组显效16例,有效11例,无效3例,总有效率90·0%;对照组显效8例,有14例,无效8例,总有效率73·3%。2组疗效对比,经统计学处理,有显著性差异(P<0·05)。[结论]健脾化湿汤治疗肠易激综合征腹泻型疗效显著。     

活血化瘀法治疗糖尿病肾病45例临床观察

目的探讨活血化瘀法治疗糖尿病肾病的临床疗效。方法选择糖尿病肾病患者90例,随机分为两组,治疗组45例,采用活血化瘀方法,对照组45例,采用益气补肾法,两组均常规应用降血糖药物。结果治疗组总有效率97.8%。对照组总有效率80%,两组比较差异有显著性,P<0.05。结论应用活血化瘀治疗糖尿病肾病(DN)疗程短,疗效显著,是治疗糖尿病肾病较为理想的方法。     

健脾和胃汤治疗功能消化不良脾胃气虚证临床研究

[目的]观察健脾和胃汤对脾胃气虚型功能性消化不良(FD)的疗效。[方法]将100例FD患者随机分为2组,治疗组50例服用健脾和胃汤,对照组50例服用吗丁啉,分别于治疗前与治疗4周后进行评分比较疗效。[结果]总有效率治疗组为86%,对照组为70%。总有效率两组比较,差异非常显著(P<0·01)。[结论]健脾和胃汤对脾胃气虚型FD有明显疗效。     

解毒保肾汤治疗早期糖尿病性肾病

[目的 ]观察解毒保肾汤治疗早期糖尿病性肾病的疗效 .[方法 ]将诊断为早期糖尿病性肾病的病人随机分为 2组 ,其中治疗组 4 4例给予解毒保肾汤 ,对照组 2 0例给予阳性对照药络汀新 ,观察治疗前后 2组病人的临床症状、空腹血糖、糖化血红蛋白量及尿蛋白排泄率等的变化 .[结果 ]治疗组总有效率为 80 % ,对照组总有效率为 6 5 % ,治疗组疗效优于对照组 ;治疗组在改善临床症状 ,降低空腹血糖、糖化血红蛋白量及尿蛋白排泄率等方面均优于对照组 .[结论 ]解毒保肾汤能够降低早期糖尿病性肾病患者的血糖、减少尿蛋白的排泄 ,具有一定的保护肾脏功能 ,对早期糖尿病性肾病有治疗作用 .     

益气补肾活血中药治疗糖尿病肾病患者26例疗效观察

[目的]观察益气补肾活血中药治疗糖尿病肾病患者临床疗效并研究其作用机理。[方法]将糖尿病肾病患者随机分成治疗组和对照组各26例,治疗组用益气补肾活血中药,对照组除中药外,其他治疗方法与治疗组相同,连续服用三个月观察疗效。[结果]治疗组显效8例,有效12例,总有效率约76．9％,与对照组比较,有显著性差异（P〈0．05）。治疗前后24h尿蛋白定量、血肌酐、尿素氮测定结果,治疗组与对照组比较差异均有显著性（P〈0．01）。[结论]益气补肾活血中药时糖尿病肾病患者具有良好的治疗效果,并能降低24h尿蛋白、改善肾功能的作用。     

健脾化瘀清毒汤配合西药治疗难治性消化性溃疡60例

目的观察健脾化瘀清毒汤配合西药治疗难治性消化性溃疡疗效。方法120例患者分为两组,对照组60例给予口服泮托拉唑钠肠溶胶囊、阿莫西林、克拉霉素治疗,治疗组在上述基础上配合自拟健脾化瘀清毒汤治疗,观察其疗效。结果治疗组总有效率96．67％,对照组总有效率85．0％,两组疗效有明显差异（X2=4．90,P〈0．05）。结论健脾化瘀清毒汤配合西药治疗消化性溃疡疗效明显优于西药对照组。     

益肾汤治疗早期糖尿病肾病30例临床观察

[目的]观察在西医治疗的基础上联合益肾汤治疗早期糖尿病肾病的临床疗效。[方法]将60例患者随机分为2组,对照组用常规西药治疗;治疗组在西药基础上加用益肾汤治疗。[结果]治疗组显效率45．16％,总有效率87．09％;对照组显效率20．00％,总有效率56．67％。显效率,总有效率治疗组明显高于对照组（P〈0．01）。[结论]益肾汤结合西药治疗早期糖尿病肾病疗效显著。     

健脾补肾汤治疗糖尿病便秘34例临床观察

目的 观察健脾补肾汤治疗糖尿病便秘的临床疗效.方法 将68例糖尿病合并便秘患者随机分为两组,治疗组用健脾补肾汤,对照组二甲双胍 麻仁润肠丸进行临床观察.结果 治疗组有效率94.12%,优于对照组82.59%(P＜0.05),两组治疗前后血糖控制情况与本组相比也有显著意义(P＜0.01),且治疗组优于对照组.结论 健脾补肾汤治疗糖尿病便秘疗效显著,有通便降糖之作用.     

益气补肾法治疗糖尿病肾病微量白蛋白尿的临床观察

[目的]观察益气补肾法结合西药治疗早期糖尿病肾病微量白蛋白尿的疗效。[方法]50例早期糖尿病肾病随机分为治疗组、对照组、治疗组在与对照组同样治疗下,加用中药治疗2个月,观察两组治疗前后尿白蛋白的变化。[结果]治疗组治疗前后24h尿白蛋白明显减少(P<0·01),而对照组治疗前后无明显差异(P>0·05)。[结论]益气补肾法治疗可降低早期糖尿病尿白蛋白的排泄,对糖尿病肾病有治疗作用。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.